Provider Demographics
NPI:1336461367
Name:WINSLOW, LISA A (RN,BSN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:A
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 BOXFORD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-3225
Mailing Address - Country:US
Mailing Address - Phone:978-689-7440
Mailing Address - Fax:
Practice Address - Street 1:207 BOXFORD ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-3225
Practice Address - Country:US
Practice Address - Phone:978-689-7440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA192743163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse